Department of Empowerment of Persons with Disabilities,
Ministry of Social Justice and Empowerment, Government of India
Acknowledgement / Resident Copy
Person with Disability Registration
Enrolment No: 193200000025080033988 Enrolment Date: 30/08/2025
PERSONAL DETAILS
Full Name in Regional
Name of Applicant Samirul Sardar সািমল সরদার
Language
Applicant Father's Name Applicant Mother's Name Rijia Bibi
Date of Birth 06/06/2002
Mobile Number 7365923215 E-Mail Id cscwbnadia@[Link]
Gender Male
Relation with PwD
Mother
(Person with Disability)
Name of Guardian / Contact No. of Guardian /
Caretaker / Attendant / Rijia Bibi Caretaker / Attendant / 7365923215
Related Related
Proof of Identity Card (See Instructions)
Identity Proof Aadhaar Card Aadhaar No. ********2840
Address of Correspondence
Address M/o Rijia Bibi, , Kanainagar, ,
Tehatta,Kanainagar
Tehatta - I Nadia
West Bengal 742121
Nature of Document
for Address Proof
DISABILITY DETAILS
Do you have disability certificate? Yes Disability Type Blindness
Disability certificate uploaded? Yes Sr. No. / Registration No. of Certificate 460
Date of Issuance of Certificate 11/12/2013 Details of Issuing Authority Medical Authority
Disability Percentage 100
Disability Due To
Hospital Treating State / UTs West Bengal Hospital Treating District Nadia
Hospital Name Sub Division Hospital-Tehetta
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